Pearls of Wisdom from a CFS Physician

Dr. Lucinda Bateman of the Fatigue Consultation Clinic in Salt Lake City, Utah provided the CFIDS Association with a list of five common truths or “pearls of wisdom” she has learned about treating ME/CFS. Dr. Bateman believes that these basic truths may help guide care for patients and health care professionals both.

Despite individual differences between patients and the complex array of CFS symptoms they experience, five core areas exist that offer improvement for almost every CFS patient. Focusing on these areas may guide the patient’s search for better care and the doctor’s approach to fulfilling those expectations.

Build emotional resilience. Dr. Bateman says that ME/CFS can be especially punishing compared to other chronic illnesses. At first family and friends are supportive and caring but when the patient doesn’t get better, it’s harder for others to understand and soon support drops off and isolation sets in. Because the symptoms are difficult to measure or prove clinically, they may be met with doubt or disapproval by those whose support is needed most. Dr. Bateman says that in order for a CFS patient to thrive, must repeatedly rejuvenate the will to live and to find joy in living,
even while chronically ill. She emphasizes that it CAN be done.

Achieve the most restorative sleep possible. When ME/CFS patients are sleeping well, and getting enough restorative sleep, their symptoms improve and they feel better overall. The trick, however, is finding out how to make this happen – which can be very difficult. Dr. Bateman says “improved sleep immediately helps not only fatigue, but pain as well, and it probably improves cognition, mood, headaches and immune function to some degree. Natural sleep is always best, but the unfortunate fact is that most CFS patients struggle with chronically disrupted and unrefreshing
sleep that’s not easily fixed. There is no doubt that left untreated, even for a few days, sleep disruption worsens most aspects of CFS.”

Those of us with ME/CFS who have the sleep disorders know that there is not a perfect remedy to make us sleep so it is what I consider an ongoing battle.

Achieve reasonable pain control. Dr. Bateman says unrelenting or severe pain is physically and mentally exhausting; it disrupts sleep, worsens mood and prevents physical activity. These are all important reasons to work on reasonable pain control.

I say reasonable” because it may be impractical to eliminate pain completely, so the goal is to push pain into the background, to feel more in control and less frightened by the pain. This can be done by both reducing the pain and by learning to manage pain psychologically.

Balance physical pacing with physical conditioning. Dr. Bateman states that the most important thing that she has learned throughout her medical career deailng with ME/CFS patients is in controlling the type, duration and intensity of activity to avoid a crash” or relapse.

Identify and treat comorbid conditions. There are a number of medical conditions,
often subtle in presentation, that frequently overlap or occur in combination (are comorbid) with CFS.
These conditions have well known diagnostic and treatment plans that a medical professional can follow whether familiar with CFS or not. Since each untreated condition may worsen CFS symptoms, any improvement in symptoms of comorbid conditions is progress in reducing the severity of CFS.